Polio & Post-Polio Syndrome

Definition

Poliomyelitis, better known as polio, is an infectious disease that was prevalent in the UK until a vaccine was discovered in 1950. The disease can cause flaccid paralysis if the virus enters the central nervous system. This paralysis may only be temporary and muscles are able to return to normal strength. However, if the paralysis is present 12 months following the infection, the paralysis is likely to be permanent.

For those people who do make a full recovery, there is a 25-50% risk of the individual developing similar symptoms of muscle weakness, or even new muscle weakness and extreme fatigue in adult life. This condition is described as post-polio syndrome (PPS). PPS is a progressive weakness for which there is no specific treatment. It is not, however, an infectious disease.

Because the first polio vaccinations were not introduced until 1955,post-polio syndrome is now becoming relatively common in patients who contracted polio in the 1940s and early 50s. According to the NHS that amounts to an estimated 120,000 people in the UK.

Symptoms/causes

Minor symptoms of the polio virus include flu-like symptoms, nausea and vomiting. When the virus enters the central nervous system, symptoms include fever, lethargy and extremity pain. Approximately five in 1,000 cases lead to symptoms of paralysis, where muscles in the extremities become weak and floppy.

In PPS, people can develop symptoms after a long time, without any significant change in their condition, people may develop new symptoms of increasing weakness, stamina problems, fatigue and pain.

Diagnosis

Individuals suffering with post polio syndrome will have had a previous diagnosis of polio, a long interval after recovery and an onset of gradual weakness. The diagnosis can be confirmed by electromyography and imaging.

If a diagnosis is confirmed, then the patient will undergo a neurological examination. This includes: analysing joint ranges of movement; joint stability; muscle strength; standing posture/alignment; and a gait/walking assessment.

Orthotic Treatment

An individual with post-polio syndrome will suffer with muscle weakness and decreased mobility. Often they will be affected in areas that were not previously affected.

Commonly-used orthoses for treatment are Ankle Foot Orthoses (AFOs) and Knee Ankle Foot Orthoses (KAFOs). These devices provide stability in stance and aid walking to improve energy efficiency and reduce pain. They are also designed to protect joints from abnormal forces.

At LOC, we only fit bespoke ankle foot orthoses. These are designed and manufactured based specifically on the individual’s requirements, following a detailed assessment and casting.

We can manufacture traditional devices, but the more modern orthoses offer more leg control. They can also be made in lighter weight materials, such as titanium and carbon fibre. In comparison to traditional calipers these modern orthoses are about a third of the weight. That is very significant. It both reduces strain on the patient and increases mobility. We have found the resulting reduction in weight a huge benefit to our PPS patients.

If desired, we can also make hybrid designs, keeping the familiar design and fitting characteristics of conventional KAFOs, but using the new lighter materials.

Further information/links

The Fellowship is able to provide direct grants to polio members towards their mobility needs this is particularly so for members in the Kingston and Wimbledon areas that close by to the LOC Head Office and Manufacturing Centre. For full details of the BPF grants and other assistance available and for membership enquires please contact the Fellowship directly: